“What I’m trying to do in our partnership with the University of Hawaii is to unite (our) efforts into one great strategic idea that will help us move forward with regard to improving health … in the Pacific Islands and territories,” said RADM Louis Tripoli.

The U.S. military’s largest command is strengthening its ties with the University of Hawaii to form a combined network of healthcare and environmental expertise to the Indo-Pacific Region.

A kickoff session Tuesday at the UH Kakaako Campus brought out high-ranking leaders from each of the military commands, from Rear Admirals and Brigadier Generals to Colonels and Sergeant Majors. The full spectrum of military doctors – flight surgeons, trauma surgeons, military medicine professors and even military pediatricians were there – absorbed in conversations and strategy sessions with UH researchers and clinicians, as well as officials from the CDC, US AID, Senator Brian Schatz and Congressman Ed Case’s offices and representatives from the embassies of nations and jurisdictions within the massive region.

Every branch of the U.S. military is active in the area, and the UH and its medical school has a long history of health care programs and capacity building in the Pacific.

“This is about all of Oceania, so it includes the U.S.-Affiliated Pacific Island (USAPI) jurisdictions that UH works with quite a lot, but also the other 22 Pacific Island countries and territories. There’s a huge burden of both chronic disease or non-communicable disease (like obesity and diabetes, heart disease, cancer and kidney disease) and also a high burden of infectious disease. The challenge is that most of these countries have insufficient infrastructure to comprehensively address and prevent these common diseases,” said Dr. Lee Bueconsejo-Lum, Director of Graduate Medical Education at the John A. Burns School of Medicine (JABSOM) and a leading investigator of cancer in the US-Affiliated Pacific Islands. “It will really range from country to country, but as an example, some jurisdictions have really very little ability to screen for cancer. Basic things that we take advantage of here – cervical cancer screening, breast cancer screening – some countries don’t even have mammography.”

“I think in this situation when it comes to all of the health efforts out there that the whole is greater than the sum of the parts,” said RDML Louis Tripoli, Command Surgeon, US INDOPACOM. “We have a lot of great efforts doing a lot of great things, but what I’m trying to do with our partnership at the University of Hawaii is to unite those efforts into one great strategic idea that will help us move forward with regard to improving health, healthcare, and healthcare support in the Pacific Islands and territories.”

The problems go beyond what happens in a health clinic and hospital, and in that capacity the UH is also equipped to assist, said Dr. Buenconsejo-Lum, who also helped arrange the meeting.

“With climate change already definitely impacting all of the Pacific Island countries, especially the low-lying ones, their ability to grow healthy food is changing, worsening the obesity problem. There’s a lot of talk about food security, and how do you help communities be healthier if they actually can’t grow their own food. UH has been working a lot with coastal communities and and helping to advise some of these countries with climate change and food security but there’s a lot more work to be done,” she said.

In addition to on-site training, she envisions people coming from the Pacific to Tripler Army Medical Center, for example, to get additional skills. “The region lacks many subspecialty physicians, critically needed technicians and other allied health professionals. Could the physicians, nurses and allied health educators in the military, UH or from the Defense Health Agency or the Uniformed Services University help train and strengthen those health personnel? she wonders. “There’s also a big need for strengthening skills in health system administration, management and financing within the individual jurisdiction’s geopolitical and resource context. You can have a great health workforce but if the administrative and management structures are not well coordinated then health care delivery will be inefficient in an already resource-limited setting,” said Buenconsejo-Lum.

Dr. Buenconsejo-Lum also says the military could supercharge some of the health workforce development programs UH has undertaken for physicians, nurses and allied health workers for the area.

“Kapiolani Community College actually has a great program training emergency medicine technicians and first responders. They’re part of a U.S. Pacific-wide network to help improve emergency response capability. Where I think we could definitely partner more with the military are for some of the other types of health workforce training,” she said.

In addition to on-site training, she envisions people coming from the Pacific to Tripler, for example, to get additional skills. “The region lacks many subspecialty physicians, critically needed technicians and other allied health professionals. Could the physicians, nurses and allied health educators in the military, UH or from the Defense Health Agency or the Uniformed Services University help train and strengthen those health personnel? she wonders. “There’s also a big need for strengthening skills in health system administration, management and financing within the individual jurisdiction’s geopolitical and resource context. You can have a great health workforce but if the administrative and management structures are not well coordinated then health care delivery will be inefficient in an already resource-limited setting,” said Buenconsejo-Lum.

Tuesday’s four-hour session was the beginning of what both sides expect to be a sustained discussion and partnership. Working groups set short-term priorities and within a month said their aim is to get more organized and bring more voices throughout the region into the conversation.

In addition to JABSOM, the University of Hawaii was also represented at the meeting by faculty of the UH Cancer Center, the Pacific Basin Telehealth Resource Center, the Office of Public Health Studies in the Myron B. Thompson School of Social Work, the School of Nursing & Dental Hygiene, the Daniel K. Inouye College of Pharmacy, Pacific Biosciences Research Center and UH System. The East-West Center also participated, as did USAPI partners from the Pacific Islands Primary Care Association and the Pacific Island Health Officers’ Association.